AG Clears 10 Firms Of Medicaid Fraud

Ten behavioral health agencies were cleared of fraud on Monday, Feb. 8, by the New Mexico attorney general. The AG’s Office found no deliberate pattern of abuse.

It’s been just over two and a half years since the state suspended funds to 15 of New Mexico’s behavioral health providers and farmed out contracts to Arizona companies instead. Attorney General Hector Balderas said officials need to be more careful when making those allegations.

“When enforcing accountability, it’s important that you have accurate information, that there be followup,” he said. “Clearly, New Mexico deserves better. Officials need to do a better job when targeting waste, fraud and abuse, that they do it in a diligent manner and that they do not disrupt services for vulnerable New Mexicans.”

The office did uncover some violations, including incorrect billing and some under-qualified staffers. There are still two investigations pending because those cases are larger and more complex, and Balderas said they should be done soon.

Kyler Nerison, spokesperson for the Human Services Department, defended his agency’s actions, saying they led to the successful recovery of $4 million in misspent funds, and said that the department disagrees with Balderas.

“The decision to not prosecute clear over-billing and misusing Medicaid funds on things like private planes and luxury travel in the tropics belongs to the attorney general,” he wrote in an email. “We respect but disagree with that decision and continue to believe that those funds should be used to help the people who need it the most.”